Use butalbital; acetaminophen; caffeine with caution in at-risk debilitated patients. Use with caution in patients with head trauma due to the CNS depressant effects of butalbital, which can cause dose-dependent CNS depression that may lead to respiratory depression.
Use with caution in patients who have a seizure disorder, because of the CNS stimulant effects of caffeine.
Use cautiously in patients who have cardiac disease or tachycardia, as caffeine can stimulate the force of myocardial contraction and can increase heart rate; it may increase left ventricular output and stroke volume, and too much caffeine may cause rapid heartbeat.